fa اختلال وسواسی- اجباری: آیا در مولتیپل اسکلروزیس شایع است؟ روانپزشکی و روانشناسی Psychiatry and Psychology پژوهشي اصيل Original Research  <p class="a0" dir="rtl" style="MARGIN-LEFT: 1cm TEXT-INDENT: 0cm"><a name="_Toc78619153"><span lang="AR-SA" style="FONT-SIZE: 20pt FONT-FAMILY: BTahoma"><font color="#cc0000" size="4">چکیده</font></span></a></p><p class="a0" dir="rtl" style="MARGIN-LEFT: 1cm TEXT-INDENT: 0cm"> <span lang="AR-SA" style="FONT-SIZE: 10pt FONT-STYLE: normal FONT-FAMILY: Tahoma mso-ansi-font-size: 9.0pt mso-ansi-font-weight: normal mso-ansi-font-style: italic"><strong>هدف:</strong></span><span lang="AR-SA" style="FONT-WEIGHT: normal FONT-SIZE: 10pt FONT-FAMILY: Tahoma mso-ansi-font-size: 9.0pt"><strong> </strong>این بررسی برای ارزیابی فراوانی علایم<font size="2"><span style="mso-spacerun: yes">  </span>اختلال وسواسی- اجباری </font></span><span dir="ltr"></span><span dir="ltr" style="FONT-WEIGHT: normal FONT-FAMILY: Tahoma"><span dir="ltr"></span>(OCD)</span><span dir="rtl"></span><span lang="AR-SA" style="FONT-WEIGHT: normal FONT-SIZE: 10pt FONT-FAMILY: Tahoma mso-ansi-font-size: 9.0pt"><span dir="rtl"></span> در بیماران مبتلا به مولتیپل اسکلروزیس </span><span dir="ltr"></span><span dir="ltr" style="FONT-WEIGHT: normal FONT-FAMILY: Tahoma"><span dir="ltr"></span>(MS)</span><span dir="rtl"></span><span lang="AR-SA" style="FONT-WEIGHT: normal FONT-SIZE: 10pt FONT-FAMILY: Tahoma mso-ansi-font-size: 9.0pt"><span dir="rtl"></span> انجام شده است.<p></p></span></p><p class="a" dir="rtl"><span lang="AR-SA" style="FONT-SIZE: 10pt FONT-STYLE: normal FONT-FAMILY: Tahoma mso-ansi-font-size: 9.0pt mso-ansi-font-weight: normal mso-ansi-font-style: italic"><strong>روش‌: </strong></span><span lang="AR-SA" style="FONT-WEIGHT: normal FONT-SIZE: 10pt FONT-FAMILY: Tahoma mso-ansi-font-size: 9.0pt">تعداد 40 نفر (18 مرد و 22 زن) از بیماران مبتلا به مولتیپل اسکلروزیس با مقیاس‌های وسواسی اجباری ییل- براون</span><span dir="ltr"></span><span dir="ltr" style="FONT-WEIGHT: normal FONT-FAMILY: Tahoma"><span dir="ltr"></span>(Y-BOCS)</span><span dir="rtl"></span><span lang="AR-SA" style="FONT-WEIGHT: normal FONT-SIZE: 10pt FONT-FAMILY: Tahoma mso-ansi-font-size: 9.0pt"><span dir="rtl"></span> و افسردگی هامیلتون </span><span dir="ltr"></span><span dir="ltr" style="FONT-WEIGHT: normal FONT-FAMILY: Tahoma"><span dir="ltr"></span>(HRSD)</span><span dir="rtl"></span><span lang="AR-SA" style="FONT-WEIGHT: normal FONT-SIZE: 10pt FONT-FAMILY: Tahoma mso-ansi-font-size: 9.0pt"><span dir="rtl"></span> ارزیابی شدند. نقاط برش این دو مقیاس به‌عنوان ملاک تشخیصی </span><span dir="ltr" style="FONT-WEIGHT: normal FONT-FAMILY: Tahoma">OCD</span><span dir="rtl"></span><span lang="AR-SA" style="FONT-WEIGHT: normal FONT-SIZE: 10pt FONT-FAMILY: Tahoma mso-ansi-font-size: 9.0pt"><span dir="rtl"></span> و اختلال افسردگی به‌کار برده شد. برای تحلیل داده‌ها به تناسب از آزمون‌های </span><span dir="ltr" style="FONT-WEIGHT: normal FONT-FAMILY: Tahoma">t</span><span dir="rtl"></span><span style="FONT-WEIGHT: normal FONT-SIZE: 10pt FONT-FAMILY: Tahoma mso-ansi-font-size: 9.0pt"><span dir="rtl"></span> <span lang="AR-SA"><font size="2">، دقیق فیشر و خی‌دو بهره گرفته شد.<p></p></font></span></span></p><p class="a" dir="rtl"><span lang="AR-SA" style="FONT-SIZE: 10pt FONT-STYLE: normal FONT-FAMILY: Tahoma mso-ansi-font-size: 9.0pt mso-ansi-font-weight: normal mso-ansi-font-style: italic"><strong>یافته‌ها:</strong></span><span lang="AR-SA" style="FONT-WEIGHT: normal FONT-SIZE: 10pt FONT-FAMILY: Tahoma mso-ansi-font-size: 9.0pt"><strong> </strong>5/17% بیماران مبتلا به </span><span dir="ltr" style="FONT-WEIGHT: normal FONT-FAMILY: Tahoma">OCD</span><span dir="rtl"></span><span lang="AR-SA" style="FONT-WEIGHT: normal FONT-SIZE: 10pt FONT-FAMILY: Tahoma mso-ansi-font-size: 9.0pt"><span dir="rtl"></span> و 2/69% آنان مبتلا به اختلال افسردگی بودند. در همه موارد </span><span dir="ltr" style="FONT-WEIGHT: normal FONT-FAMILY: Tahoma">OCD</span><span dir="rtl"></span><span lang="AR-SA" style="FONT-WEIGHT: normal FONT-SIZE: 10pt FONT-FAMILY: Tahoma mso-ansi-font-size: 9.0pt"><span dir="rtl"></span>، بیمار شروع علایم آن را مربوط به پیش از شروع تظاهرات بالینی </span><span dir="ltr" style="FONT-WEIGHT: normal FONT-FAMILY: Tahoma">MS</span><span dir="rtl"></span><span lang="AR-SA" style="FONT-WEIGHT: normal FONT-SIZE: 10pt FONT-FAMILY: Tahoma mso-ansi-font-size: 9.0pt"><span dir="rtl"></span> می‌دانست. سطح تحصیل بیماران </span><span dir="ltr" style="FONT-WEIGHT: normal FONT-FAMILY: Tahoma">OCD</span><span dir="rtl"></span><span lang="AR-SA" style="FONT-WEIGHT: normal FONT-SIZE: 10pt FONT-FAMILY: Tahoma mso-ansi-font-size: 9.0pt"><span dir="rtl"></span> به‌طور معنی‌داری بیش از بیماران غیر </span><span dir="ltr" style="FONT-WEIGHT: normal FONT-FAMILY: Tahoma">OCD</span><span dir="rtl"></span><span lang="AR-SA" style="FONT-WEIGHT: normal FONT-SIZE: 10pt FONT-FAMILY: Tahoma mso-ansi-font-size: 9.0pt"><span dir="rtl"></span> بود (05/0</span><span dir="ltr"></span><span lang="AR-SA" dir="ltr" style="FONT-WEIGHT: normal FONT-FAMILY: Tahoma"><span dir="ltr"></span> </span><span dir="ltr" style="FONT-WEIGHT: normal FONT-FAMILY: Tahoma">p<</span><span dir="rtl"></span><span lang="AR-SA" style="FONT-WEIGHT: normal FONT-SIZE: 10pt FONT-FAMILY: Tahoma mso-ansi-font-size: 9.0pt"><span dir="rtl"></span>). فراوانی وسواس به‌طور معنی‌داری بیش از فراوانی اجبار (0001/0</span><span dir="ltr"></span><span lang="AR-SA" dir="ltr" style="FONT-WEIGHT: normal FONT-FAMILY: Tahoma"><span dir="ltr"></span> </span><span dir="ltr" style="FONT-WEIGHT: normal FONT-FAMILY: Tahoma">p<</span><span dir="rtl"></span><span lang="AR-SA" style="FONT-WEIGHT: normal FONT-SIZE: 10pt FONT-FAMILY: Tahoma mso-ansi-font-size: 9.0pt"><span dir="rtl"></span>) و شایع‌ترین وسواس، «تردید» بود. فراوانی </span><span dir="ltr" style="FONT-WEIGHT: normal FONT-FAMILY: Tahoma">OCD</span><span dir="rtl"></span><span lang="AR-SA" style="FONT-WEIGHT: normal FONT-SIZE: 10pt FONT-FAMILY: Tahoma mso-ansi-font-size: 9.0pt"><span dir="rtl"></span> در بیماران افسرده و غیرافسرده تفاوت معنی‌دار نداشت.<p></p></span></p><p class="a" dir="rtl"><span lang="AR-SA" style="FONT-SIZE: 10pt FONT-STYLE: normal FONT-FAMILY: Tahoma mso-ansi-font-size: 9.0pt mso-ansi-font-weight: normal mso-ansi-font-style: italic"><strong>نتیجه‌گیری:</strong></span><span lang="AR-SA" style="FONT-WEIGHT: normal FONT-SIZE: 10pt FONT-FAMILY: Tahoma mso-ansi-font-size: 9.0pt"><strong> </strong>فراوانی </span><span dir="ltr" style="FONT-WEIGHT: normal FONT-FAMILY: Tahoma">OCD</span><span dir="rtl"></span><span lang="AR-SA" style="FONT-WEIGHT: normal FONT-SIZE: 10pt FONT-FAMILY: Tahoma mso-ansi-font-size: 9.0pt"><span dir="rtl"></span> در بیماران </span><span dir="ltr" style="FONT-WEIGHT: normal FONT-FAMILY: Tahoma">MS</span><span dir="rtl"></span><span lang="AR-SA" style="FONT-WEIGHT: normal FONT-SIZE: 10pt FONT-FAMILY: Tahoma mso-ansi-font-size: 9.0pt"><span dir="rtl"></span> قابل توجه است و این فراوانی را نمی‌توان صرفاً با میزان بالای همبودی اختلال افسردگی توجیه نمود.<p></p></span></p><p class="a" dir="rtl"><p class="a" dir="rtl"><span lang="AR-SA" style="FONT-WEIGHT: normal FONT-SIZE: 10pt FONT-FAMILY: Tahoma mso-ansi-font-size: 9.0pt"><p></p></span></p> </p> <p><font color="#cc0000"> <strong> Abstract </strong></font></p><p> <strong> Objectives: </strong>The aim of this study was to identify the frequency of the symptoms of obsessive compulsive disorder (OCD) in patients with multiple sclerosis (MS). </p><p> <strong> Method: </strong>Forty patients (18 males and 22 females) were evaluated via clinician-administered Yale-Brown Obsessive Compulsive Scale <br>(Y- BOCS) and Hamilton Rating Scale for Depression (HRSD). The cutoff points of these scales were used as diagnostic criteria for OCD and depressive disorder. T-test, Fisher's exact test and chi-square were used to analyze data. </p><p> <strong> Results: </strong>17.5% of patients had OCD and 69.2% had depressive dis- order. In all cases of OCD, the patients described the onset of symptoms to have begun before the clinical presentations of MS. Educational level of OCD cases was significantly higher than the non-OCD group (p<0.05). The frequency of obsession was significantly higher than compulsion (p<0.0001), and the most common obsession was “doubt”. The frequency of OCD was not significantly different between depressed and non-depressed patients. </p><strong>Conclusion: </strong>The frequency of OCD in MS patients is significant and it cannot be accounted for by a high rate of comorbidity of depressive disorder. کلیدواژه: مولتیپل اسکلروزیس، اختلال وسواسی- اجباری، افسردگی، Y-BOCS Key words: multiple sclerosis, obsessive-compulsive disorder, depression, Y-BOCS 209 215 http://ijpcp.iums.ac.ir/browse.php?a_code=A-10-1-4&slc_lang=fa&sid=1 Amir Shabani امیر شعبانی E-mail: amirshabani@tehranpi.org 1800319475328460053 1800319475328460053 Yes Somaieh Nikravesh سمیه نیک‌روش 1800319475328460054 1800319475328460054 No Leili Panaghi لیلی پناغی 1800319475328460055 1800319475328460055 No